Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson's disease.
Identifieur interne : 002500 ( PubMed/Checkpoint ); précédent : 002499; suivant : 002501Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson's disease.
Auteurs : Uwe Walter [Allemagne] ; Dirk Dressler ; Alexander Wolters ; Matthias Wittstock ; Reiner BeneckeSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Cerebral Ventricles (pathology), Cerebral Ventricles (ultrasonography), Female, Humans, Male, Middle Aged, Parkinson Disease (classification), Parkinson Disease (pathology), Parkinson Disease (ultrasonography), Prospective Studies, Sensitivity and Specificity, Ultrasonography, Doppler, Transcranial.
- MESH :
- classification : Parkinson Disease.
- pathology : Cerebral Ventricles, Parkinson Disease.
- ultrasonography : Cerebral Ventricles, Parkinson Disease.
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Ultrasonography, Doppler, Transcranial.
Abstract
To investigate whether transcranial brain sonography (TCS) discriminates different courses of idiopathic Parkinson's disease (PD), 101 patients with clinically definite PD were studied. In four patients, TCS was not possible due to insufficient acoustic temporal bone windows. Substantia nigra (SN) hyperechogenicity was found in 96% of assessable patients. Larger SN echogenic size correlated with younger age at PD onset (Spearman correlation, r = -0.383; P < 0.001), but not with age, PD duration, or severity. Marked bilateral SN hyperechogenicity indicated early-onset rather than late-onset PD, and akinetic-rigid (AR) or mixed-type (MX) PD rather than tremor-dominant PD. SN echogenic sizes were larger contralateral to the clinically more affected side in AR PD and MX PD patients. Reduced echogenicity of brainstem raphe was associated with depression (RR = 1.61; 95% CI = 1.05-2.46; P = 0.044) but not with other clinical features. Caudate nucleus hyperechogenicity was, independently from PD duration, related to drug-induced psychosis (RR = 2.40; CI = 1.36-4.22; P = 0.001), but not to motor fluctuations. Lenticular nucleus hyperechogenicity indicated AR PD rather than tremor-dominant PD (RR = 1.44; CI = 1.11-1.86; P = 0.040). Frontal horn dilatation > 15.4 mm (mean of bilateral measurements) indicated increased risk of dementia (RR = 4.11; CI = 1.51-11.2; P = 0.001). We conclude that TCS displays characteristic changes of deep brain structures in different clinical manifestations of PD.
DOI: 10.1002/mds.21197
PubMed: 17083096
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson's disease.</title><author><name sortKey="Walter, Uwe" sort="Walter, Uwe" uniqKey="Walter U" first="Uwe" last="Walter">Uwe Walter</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University of Rostock, Rostock, Germany. uwe.walter@med.uni-rostock.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University of Rostock, Rostock</wicri:regionArea><wicri:noRegion>Rostock</wicri:noRegion><wicri:noRegion>Rostock</wicri:noRegion><wicri:noRegion>Rostock</wicri:noRegion></affiliation></author><author><name sortKey="Dressler, Dirk" sort="Dressler, Dirk" uniqKey="Dressler D" first="Dirk" last="Dressler">Dirk Dressler</name></author><author><name sortKey="Wolters, Alexander" sort="Wolters, Alexander" uniqKey="Wolters A" first="Alexander" last="Wolters">Alexander Wolters</name></author><author><name sortKey="Wittstock, Matthias" sort="Wittstock, Matthias" uniqKey="Wittstock M" first="Matthias" last="Wittstock">Matthias Wittstock</name></author><author><name sortKey="Benecke, Reiner" sort="Benecke, Reiner" uniqKey="Benecke R" first="Reiner" last="Benecke">Reiner Benecke</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2007">2007</date><idno type="doi">10.1002/mds.21197</idno><idno type="RBID">pubmed:17083096</idno><idno type="pmid">17083096</idno><idno type="wicri:Area/PubMed/Corpus">002A10</idno><idno type="wicri:Area/PubMed/Curation">002A10</idno><idno type="wicri:Area/PubMed/Checkpoint">002500</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson's disease.</title><author><name sortKey="Walter, Uwe" sort="Walter, Uwe" uniqKey="Walter U" first="Uwe" last="Walter">Uwe Walter</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University of Rostock, Rostock, Germany. uwe.walter@med.uni-rostock.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University of Rostock, Rostock</wicri:regionArea><wicri:noRegion>Rostock</wicri:noRegion><wicri:noRegion>Rostock</wicri:noRegion><wicri:noRegion>Rostock</wicri:noRegion></affiliation></author><author><name sortKey="Dressler, Dirk" sort="Dressler, Dirk" uniqKey="Dressler D" first="Dirk" last="Dressler">Dirk Dressler</name></author><author><name sortKey="Wolters, Alexander" sort="Wolters, Alexander" uniqKey="Wolters A" first="Alexander" last="Wolters">Alexander Wolters</name></author><author><name sortKey="Wittstock, Matthias" sort="Wittstock, Matthias" uniqKey="Wittstock M" first="Matthias" last="Wittstock">Matthias Wittstock</name></author><author><name sortKey="Benecke, Reiner" sort="Benecke, Reiner" uniqKey="Benecke R" first="Reiner" last="Benecke">Reiner Benecke</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007" type="published">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cerebral Ventricles (pathology)</term><term>Cerebral Ventricles (ultrasonography)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (classification)</term><term>Parkinson Disease (pathology)</term><term>Parkinson Disease (ultrasonography)</term><term>Prospective Studies</term><term>Sensitivity and Specificity</term><term>Ultrasonography, Doppler, Transcranial</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Cerebral Ventricles</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="ultrasonography" xml:lang="en"><term>Cerebral Ventricles</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Sensitivity and Specificity</term><term>Ultrasonography, Doppler, Transcranial</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To investigate whether transcranial brain sonography (TCS) discriminates different courses of idiopathic Parkinson's disease (PD), 101 patients with clinically definite PD were studied. In four patients, TCS was not possible due to insufficient acoustic temporal bone windows. Substantia nigra (SN) hyperechogenicity was found in 96% of assessable patients. Larger SN echogenic size correlated with younger age at PD onset (Spearman correlation, r = -0.383; P < 0.001), but not with age, PD duration, or severity. Marked bilateral SN hyperechogenicity indicated early-onset rather than late-onset PD, and akinetic-rigid (AR) or mixed-type (MX) PD rather than tremor-dominant PD. SN echogenic sizes were larger contralateral to the clinically more affected side in AR PD and MX PD patients. Reduced echogenicity of brainstem raphe was associated with depression (RR = 1.61; 95% CI = 1.05-2.46; P = 0.044) but not with other clinical features. Caudate nucleus hyperechogenicity was, independently from PD duration, related to drug-induced psychosis (RR = 2.40; CI = 1.36-4.22; P = 0.001), but not to motor fluctuations. Lenticular nucleus hyperechogenicity indicated AR PD rather than tremor-dominant PD (RR = 1.44; CI = 1.11-1.86; P = 0.040). Frontal horn dilatation > 15.4 mm (mean of bilateral measurements) indicated increased risk of dementia (RR = 4.11; CI = 1.51-11.2; P = 0.001). We conclude that TCS displays characteristic changes of deep brain structures in different clinical manifestations of PD.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">17083096</PMID><DateCreated><Year>2007</Year><Month>01</Month><Day>29</Day></DateCreated><DateCompleted><Year>2007</Year><Month>04</Month><Day>05</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>22</Volume><Issue>1</Issue><PubDate><Year>2007</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>48-54</MedlinePgn></Pagination><Abstract><AbstractText>To investigate whether transcranial brain sonography (TCS) discriminates different courses of idiopathic Parkinson's disease (PD), 101 patients with clinically definite PD were studied. In four patients, TCS was not possible due to insufficient acoustic temporal bone windows. Substantia nigra (SN) hyperechogenicity was found in 96% of assessable patients. Larger SN echogenic size correlated with younger age at PD onset (Spearman correlation, r = -0.383; P < 0.001), but not with age, PD duration, or severity. Marked bilateral SN hyperechogenicity indicated early-onset rather than late-onset PD, and akinetic-rigid (AR) or mixed-type (MX) PD rather than tremor-dominant PD. SN echogenic sizes were larger contralateral to the clinically more affected side in AR PD and MX PD patients. Reduced echogenicity of brainstem raphe was associated with depression (RR = 1.61; 95% CI = 1.05-2.46; P = 0.044) but not with other clinical features. Caudate nucleus hyperechogenicity was, independently from PD duration, related to drug-induced psychosis (RR = 2.40; CI = 1.36-4.22; P = 0.001), but not to motor fluctuations. Lenticular nucleus hyperechogenicity indicated AR PD rather than tremor-dominant PD (RR = 1.44; CI = 1.11-1.86; P = 0.040). Frontal horn dilatation > 15.4 mm (mean of bilateral measurements) indicated increased risk of dementia (RR = 4.11; CI = 1.51-11.2; P = 0.001). 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